Anais Holland-Rudd Associate Editor Loyola University Chicago School of Law, JD 2018 Niurka Fernandez, 54, and her son Roberto Alvarez, 26, both plead guilty on August 31, 2016 to one count of conspiracy to commit health care fraud. On November 10th, Fernandez was sentenced to 120 months in prison while Alvarez was sentenced to …Read more

Mac Matarieh Associate Editor Loyola University Chicago School of Law, JD 2018 Inside of President-Elect Donald Trump’s 100 Day Action Plan is a requirement that for every new federal regulation, two existing regulations would be eliminated. Mr. Trump has consistently pushed the narrative of an outright repeal of the Affordable Care Act. Further, Mr. …Read more

Fannie Fang Executive Editor Loyola University Chicago School of Law, JD 2017 Traditionally, only healthcare corporations were held responsible for healthcare fraud. During an investigation, these corporations were only required to provide contextual information about the underlying factual situation in a fraud investigation. Additionally, healthcare corporations would typically enter into settlement agreements with the …Read more

Alanna Kroeker Executive Editor Loyola University Chicago School of Law, JD 2017 As our MACRA 101 series comes to an end, this article is intended to point out key differences between the proposed rule released earlier this year and the final rule which was released October 14th. The lengthy final rule, reaching almost 2,400 …Read more

Fannie Fang Executive Editor Loyola University Chicago School of Law, JD 2017 CMS has reported that Medicare expenditures amount to roughly 17 billion a year on patient readmissions alone. Studies show that almost twenty percent of all patients who are admitted to a U.S. hospital makes a repeat visit within thirty days of discharge. …Read more

Bherti Patel Associate Editor Loyola University Chicago School of Law, JD 2018 The Quality Payment Program (QPP) will reward delivery of quality patient care through the following two programs: the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs). These two programs will allow clinicians and physicians to provide care in a …Read more

Christine Bulgozdi Associate Editor Loyola University Chicago School of Law, JD 2018 The Merit-based Incentive Payment System (“MIPS”) is one of the two different payment methods that MACRA will use for eligible clinicians. Clinicians will be evaluated based on a single Composite Performance Score from four reporting categories: Quality, Resource Use, Advancing Care Information and …Read more

Alanna Kroeker Executive Editor Loyola University Chicago School of Law, JD 2017 This article will spell out the details for the Advancing Care Information (ACI) category of the Merit Based Incentive Payment System (MIPS). This category accounts for 25% of a clinician’s overall composite score and is intended to replace the current Meaningful Use …Read more

Bherti Patel Associate Editor Loyola University Chicago School of Law, JD 2018 As previously discussed, MIPS will streamline Medicare’s current quality measures into one composite score from four reporting categories: Quality, Resource Use, Advancing Care Information, and Clinical Practice Improvement. This score will then be used to determine the reimbursement to a clinician based …Read more

Christine Bulgozdi Associate Editor Loyola University Chicago School of Law, JD 2018 The Merit-based Incentive Payment System (“MIPS”) is one of the two different payment methods that MACRA will use for eligible clinicians. MIPS replaces the existing fee-for-service model and is expected to be the payment track that most clinicians take. Clinicians will be evaluated …Read more